Spotlight: The Medicare Promoting Interoperability Program vs. MIPS Promoting Interoperability Performance Category

Learn More About the Similarities and Differences Between the Medicare Promoting Interoperability Program and MIPS Promoting Interoperability Performance Category

The Centers for Medicare & Medicaid Services (CMS) has made significant strides in relieving regulatory burdens for providers; supporting the patient-doctor relationship in healthcare; and promoting transparency, flexibility, and innovation in the delivery of care.

In recent years, to continue their commitment to promoting and prioritizing interoperability, CMS has made updates to their quality reporting programs to align with these goals. These changes included renaming the EHR Incentive Programs to the Promoting Interoperability Programs and renaming the Advancing Care Information performance category of the Merit-based Incentive Payment System (MIPS) to the Promoting Interoperability performance category.

To better understand the similarities and differences between the Medicare Promoting Interoperability Program and the Promoting Interoperability performance category of MIPS, detailed criteria is listed below:

Who is eligible to participate in each program?

• Only eligible hospitals and critical access hospitals can participate in the Medicare Promoting Interoperability Program
• Only Medicare eligible clinicians can participate in MIPS which is one of two ways to participate in the Quality Payment Program

What criteria is specific to the Medicare Promoting Interoperability Program?

• Performance-based scoring methodology comprised of 100 total points available with a required minimum of 50 points
• Report on 4 of 8 available electronic clinical quality measures
• Attest through the CMS Hospital Quality Reporting System (also referred to as the QualityNet Secure Portal)
• Hardship exception applications are available after the data submission period has ended

What criteria is specific to the Promoting Interoperability Performance Category of MIPS?

• 1 of 4 performance categories
• 25% of total MIPS score
• Ability to submit data manually or through a file upload on qpp.cms.gov or through a third-party vendor
• Hardship exception applications are available prior to the data submission period

What criteria must both the Medicare Promoting Interoperability Program and Promoting Interoperability Performance Category follow?

• Minimum of a continuous 90-day required reporting period
• Required use of 2015 Edition CEHRT
• Report on 4 objectives
• Must submit a “Yes” to:
  • The Prevention of Information Blocking Attestation
  • The ONC Direct Review Attestation
  • The Security Risk Analysis measure

Resources

For more information, view the Medicare Promoting Interoperability Program vs. MIPS Promoting Interoperability Performance Category Fact Sheet. Additionally, visit the Promoting Interoperability Programs website and the Quality Payment Program website for additional resources.